Delayed unilateral vocal cord paralysis caused by minor head trauma

Vocal cord paralysis caused by lower cranial nerve paralysis originating from skull base fracture is rare. Delayed unilateral glossopharyngeal and vagus nerve paralysis after minor head injury is extremely rare. In this paper, we present the case of a 49-year-old man who sustained delayed-onset right vocal cord paralysis and dysphagia in a fighting accident. High-resolution computed tomography of the skull base revealed a bony disruption in the wall of the jugular foramen. Cranial nerve paralysis may be a distinguishable sign of skull base fracture in head injuries. Considering the severe consequences of the injury, comprehensive neurological and radiological examinations are required to evaluate the condition of the skull base. Such patients can be treated conservatively with nasogastric or gastrostomy feeding to avoid choking and aspiration. Thyroplasty may be considered for patients in whom choking persists for more than 6 months.